[Hereditary nonpolyposis colorectal cancer: analysis of a case and review of management]. / Cáncer colorrectal no polipósico hereditario: análisis de un caso y revisión del manejo.

INTRODUCTION: Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, represents 5% to 7% of colorectal cancers. It is an autosomal dominant inherited disorder characterized by an early onset of colorectal tumors, predominantly proximal, and multiple and microsatellite instability. We used the Amsterdam II criteria for its identification. OBJECTIVE: To analyze the case of a patient with a family history of malignant colorectal tumors at an early age of onset. CASE REPORT: A 40-year-old woman, from Valle de Punilla, Cordoba, Argentina, with no previous medical history, complained of mild changes in her bowel habits and was admitted to the general surgery department with the radiographic diagnosis of a tumor in the hepatic flexure of the colon. She underwent a right hemicolectomy for a Dukes B stenosing tumor (T3N0M0, stage IIa). CONCLUSION: In this report, we present the case of a woman with HNPCC who met the Amsterdam II criteria II. Family members who meet these criteria should be screened for the mutation in MMR genes. As genetic tests are not routinely available, an annual colonoscopic surveillance of all asymptomatic relatives older than 25 to 30 years old who meet the criteria is recommended, regardless of the availability and/or the outcome of genetic testing.

Hydatid liver disease: our 25-year experience.

BACKGROUND: Hydatid disease is a zoonosis caused by Echinococcus spp., which inhabits the intestine of some canines (dog). Humans are accidental intermediate hosts and can accommodate one or more cysts in different locations, mainly the liver and lungs. The standard treatment of hydatid disease has historically been surgical, including conservative and radical procedures. The disease is considered endemic in the area around Hospital Provincial "Domingo Funes," Córdoba, Argentina. METHODS: We conducted a retrospective and descriptive study that included 57 patients diagnosed with hydatid liver disease who were treated surgically from January 1985 to December 2009. RESULTS: Females represented 50.9% of the subjects with a mean age of 53 years. The main clinical presentation was pain in 56% of patients and palpable mass in 33.3%. In 93% of cases we used ultrasonography as a diagnostic method (100% sensitivity). Erythrocyte sedimentation rate was increased in 63%. Total cystectomy was performed on 47.4% of patients. Surgical morbidity was 29.8%. Surgical mortality was zero. The average number of days of hospitalization was 12. CONCLUSIONS: Clinical and epidemiological analysis is the mainstay of diagnosis, supplemented by ultrasound, CT scan and blood tests. We suggest total cystectomy as the first surgical choice, when feasible, due to its lower morbidity/mortality and shorter postoperative hospital stay, according to similar series.